Ultrasound-guided genicular nerve block versus physical therapy for chronic knee osteoarthritis: a prospective randomised study

Tuba Güler, Fatma Gül Yurdakul, Mustafa Erkut Önder, Faruk Erdoğan, Kaan Yavuz, Elif Becenen, Aslı Uçkun, Hatice Bodur, Tuba Güler, Fatma Gül Yurdakul, Mustafa Erkut Önder, Faruk Erdoğan, Kaan Yavuz, Elif Becenen, Aslı Uçkun, Hatice Bodur

Abstract

To compare the effectiveness of ultrasound-guided genicular nerve block (GNB) and physical therapy (PT) in patients with chronic knee osteoarthritis. A prospective randomised study with 102 patients (45-70 years) was performed wherein the patients received ultrasound-guided GNB (n = 51) and PT (n = 51) along with a standard home exercise programme. Scores for pain on a Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 6-min walking test (6MWT) were assessed pre-treatment and at 2- and 12-weeks post-treatment. Both groups were comparable for sociodemographic characteristics. VAS scores (in mm) in the ultrasound-guided GNB group at 0, 2 and 12 weeks were 7.01 ± 1.36; 3.71 ± 2.18; 5.08 ± 2.22 (p < 0.001) and 6.64 ± 1.99; 4.35 ± 1.09; 5.25 ± 1.33, (p < 0.001) in the PT group. While the increase in the 6MWT test in the 2nd week was similar for both groups (p = 0.073), the increase in walking distance was greater in the ultrasound-guided GNB group at 12 weeks (p = 0.046). As compared to PT, ultrasound-guided GNB is beneficial in reducing pain and increasing functional and physical capacity, with greater retention of effects on the physical capacity seen at 12 weeks. Trial registration number: ClinicalTrials.gov (NCT04782401).

Keywords: Knee joint; Nerve block; Osteoarthritis; Physical therapy modalities; Ultrasound.

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Figures

Fig. 1
Fig. 1
Sonographic image of the inferomedial genicular artery
Fig. 2
Fig. 2
The in-plane needle for inferomedial genicular nerve block
Fig. 3
Fig. 3
Flowchart of the study participants
Fig. 4
Fig. 4
Improvement in Visual Analogue Scale (VAS) scores
Fig. 5
Fig. 5
Improvement in the Western Ontario and McMaster Universities (WOMAC) scores
Fig. 6
Fig. 6
Improvement in 6-min walking test scores

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